Contraceptive Counselling: Factors that Influence Canaddian Women's Decisions
ESC Congress Library. Cook J. May 10, 2018; 208212; ESC324
Dr. Jocelynn Cook
Dr. Jocelynn Cook
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Canadian women, on average, spend fewer than 3 years pregnant, attempting to conceive, or in the immediate postpartum period.  The national average maternal age at first birth is currently over 30 years, and the trend of later age at the birth of a first child means that Canadians are spending at least half of their reproductive lives at risk for an unintended pregnancy.  Recent data report that 61% of pregnancies in Canada are unplanned.  The persistent need for abortion services indicates that the contraceptive needs of Canadian women are not being met and that different approaches to the provision of contraception are necessary to meet these needs.  Furthermore, the most recent data from a study exploring 10 years trends in contraceptive use among Canadians suggests that a significant proportion are not using contraception effectively; despite a range of contraceptive options, Canadian women tend to use a narrow selection of contraceptive methods and are inconsistent about their use The purpose of this study was to gather data on contraception-related beliefs, practices and preferences of women in Canada. The Society of Obstetricians and Gynaecologists of Canada (SOGC) worked with content experts to develop an accredited practice assessment training program for primary healthcare providers in Canada focussed on contraceptive counselling.  Data were collected about patient's contraceptive choices and the associated reasons (N=2,180).  The patient assessment revealed that most patients were between 20-30 years old (26.6% were 21-25 years and 25.4% were 26-30 years) and 64.2% were nulliparous.  Forty-three percent were using oral contraceptives presently and 24.8% were unsatisfied with their current type of birth control.  After counselling, patients reported being most comfortable with IUC (52.4%). The greatest barriers to IUC were having a foreign body inserted and worry about uterine perforation. Together, these data suggest that more education and counselling is required to help Canadian women make effective contraceptive choices, especially related to IUCs.  These findings will be used to inform the development of tools, resources and educational programming for healthcare providers, girls, women and the general public.
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